Hilar Cholangiocarcinoma Clinical Trial
Official title:
Percutaneous Bilateral Versus Unilateral Metal Stent Placement for Hilar Cholangiocarcinoma : A Prospective Open-label Randomized Controlled Trial
Cholangiocarcinoma (CCA) is the most common biliary malignancy and the second most common
hepatic malignancy after hepatocellular carcinoma (HCC). A majority of the CCA (50-70%) was
presented in the area of the biliary duct bifurcation. Recent retrospective study included
heterogeneous group of malignant diseases demonstrate that draining more than 50% of was
associated with a longer median survival.
However, in recent European Society of Gastrointestinal Endoscopy (ESGE) biliary stenting
clinical guideline and Asia-Pacific consensus recommendations for endoscopic and
interventional management of hilar cholangiocarcinoma (HCCA), whether we should deployment
bilateral or unilateral metal stent for patients with HCCA was not clearly recommended due to
the absence of randomized controlled trials.
Patients with advanced hilar obstruction (Bismuth III and IV), PTBS had a higher success rate
of cholestasis palliation and a low rate of post cholangitis when compared with endoscopic
retrograde cholangiopancreatography(ERCP). The advantage of percutaneous approach is the
precise lobar selection for drainage and this approach should yield a lower rate of
cholangitis.
Guideline recommendation European Society of Gastrointestinal Endoscopy (ESGE) biliary
stenting clinical guideline and Asia-Pacific consensus recommendations the goal of palliative
stenting of HCCA is drainage of adequate liver volume (50% or more), irrespective of
unilateral, bilateral, or multi-segmental stenting was based on heterogeneous group of
malignancy by ERCP in retrospective study.There are no randomized clinical trials compared
with these two internal biliary drainage methods in HCCA using metal stent.
The aim of the present study was to compare the effect and safety of bilateral versus
unilateral stenting in patients with HCCA.
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